Information Thread: PTSD

by **Butterfly Faerie** » Sun May 14, 2006 10:05 pm

This thread is stictly for information that is regarding post-traumatic stress disorder (PTSD).
If anyone wants to discuss anything that is posted here then please make a seperate post about it and than we can discuss.

If you have any information that relates to this subject and consider it helpful then please feel free to post it .... and I'll add it to the index on this page.

1. Brief Tips about Self-Care and Self-Help Following Disasters
2. Grounding Techniques For PTSD
3. Symptoms of PTSD
4. Conditioned Memory
5. Defense Mechanisms
6. How does trauma effect relationships
7. Understanding Memory Storage and Recall
8. Triggers and Desensitization
9. General Information On PTSD
10. Causes of PTSD
11. Acute Stress Disorder
12. What Is Psychological Trauma?
13. Symptoms: Acute Stress Disorder
14. Positive Motivations for Sexual Healing After Abuse

Page-2

15. Somatic Memory (Body Memory)
16. The Stockholm Syndrome
17. Anger & PTSD
18. PTSD & Avoidance
19. 3 types of PTSD symptoms
20. Intrusive Symptoms
21. Symptoms of Avoidance
22. Symptoms of Hyperarousal
23. PTSD & Secondary Wounding
24. Mass Disasters, Trauma, and Loss
25. Complex PTSD
26. Effects of Trauma
27. Associated Problems
28. Nightmares
29. The signs of unresolved trauma

A National Center for PTSD Fact Sheet

The emotional effects of the recent terrorist attacks will be felt by people everywhere: victims, bereaved family members, friends, rescue workers, emergency medical care providers, mental-health care providers, witnesses to the event, volunteers, members of the media, and citizens of the community, the country, and the world. Those who were at the scene and those who have lost loved ones will almost certainly have strong reactions. People who saw or heard about the attacks on TV may also have strong reactions.

Common reactions to traumatic events like the terrorist attack include feeling afraid, sad, horrified, helpless, angry, overwhelmed, confused, distracted, emotionally numb, or disoriented. People may also be bothered by nightmares or upsetting thoughts and images that come to mind. Young children may be upset, distracted, or feel out of sorts. These are normal reactions to very stressful events. With the help of family and friends, most people gradually feel better as time goes by.

What can people do to cope?

Spend time with other people. Coping with stressful events is easier when people support each other.
If it helps, talk about how you are feeling. Be willing to listen to others who need to talk about how they feel.
Get back to your everyday routines. Familiar habits can be very comforting.
Take time to grieve and cry if you need to. To feel better in the long run, you need to let these feelings out instead of pushing them away or hiding them.
Ask for support and help from your family, friends, church, or other community resources. Join or develop support groups.
Set small goals to tackle big problems. Take one thing at a time instead of trying to do everything at once.
Eat healthy food and take time to walk, stretch, exercise, and relax, even if just for a few minutes at a time.
Make sure you get enough rest and sleep. People often need more sleep than usual when they are very stressed.
Do something that just feels good to you like taking a warm bath, taking a walk, sitting in the sun, or petting your cat or dog.
If you are trying to do too much, try to cut back by putting off or giving up a few things that are not absolutely necessary.
Find something positive you can do. Give blood. Donate money to help victims of the attack. Join efforts in your community to respond to this tragedy.
Get away from the stress of the event sometimes. Turn off the TV news reports and distract yourself by doing something you enjoy.

What can adults do to help children cope?

Let them know you understand their feelings.
Tell them that they really are safe.
Keep to your usual routines.
Keep them from seeing too many frightening pictures of the events.
Educate yourself about how to talk to children of different ages about trauma.

When should a person seek more help?

Sometimes people need extra help to deal with a traumatic event. People directly affected by this tragedy, young children, people who have been through other traumatic events, and people with emotional problems are more likely to need professional help. A person may need extra help coping if a month after the attack he or she:

Still feels very upset or fearful most of the time
Acts very differently compared to before the trauma
Can't work or take care of kids or home
Has important relationships that are continuing to get worse
Uses drugs or drinks too much
Feels jumpy or has nightmares a lot
Still can't stop thinking about the attack
Still can't enjoy life at all
Where can one go to get help?

Listed beloware some ways to find help. When you call, tell whomever you speak to that you are trying to find a mental-health provider who specializes in helping people who have been through traumatic events and/or who have lost loved ones. Check this website regularly for updated information on how to get help. We will be listing more ways to get help as they become available.

For veterans

VA medical centers and Vet Centers provide veterans with mental-health services that health insurance will cover or that costs little or nothing, according to a veteran's ability to pay. VA medical centers and Vet Centers are listed in the phone book in the blue Government pages. Under "United States Government Offices," look in the section for "Veterans Affairs, Dept of." In that section look for VA Medical Centers and Clinics listed under "Medical Care" and for "Vet Centers - Counseling and Guidance," and call the one nearest to where you live. On the Internet, go to www.va.gov/ and look for the VHA Facilities Locator link under "Health Benefits and Services," or go to www.va.gov/rcs.

For non-veterans

Some local mental-health services are listed in the phone book in the blue Government pages. In the "County Government Offices" section for the county where you live, look for a "Health Services (Dept. of)" or "Department of Health Services" section. In that section, look for listings under "Mental Health." In the yellow pages, services and mental-health professionals are listed under "counseling," "psychologists," "social workers," "psychotherapists," "social and human services," or "mental health." Health insurance may pay for mental-health services and some are available at low cost according to your ability to pay.

For anyone

Call your doctor's office or ask friends if they can recommend any mental-health providers.

If you work for a large company or organization, call the Human Resources or Personnel office to find out if they provide mental-health services or make referrals.

If you are a member of a Health Maintenance Organization (HMO), call to find out if mental-health services are available.

Call the National Center for Victims of Crime's toll-free information and referral service at 1-800-FYI-CALL. This is a comprehensive database of more than 6,700 community service agencies throughout the country that directly support victims of crime.

NCPTSD

by **Butterfly Faerie** » Sun May 14, 2006 10:09 pm

Grounding Techniques For PTSD

Sensory Awareness Grounding Skills

Keep your eyes open, look around the room, notice your surroundings, notice details.

Hold a pillow, stuffed animal or a bell.

Place a cool cloth on your face, or hold something cool such as a can of soda.
Listen to soothing music.

Put your feet firmly on the ground.

FOCUS on someone's voice or a neutral conversation.

Cognitive Grounding Skills

Reorient yourself in place and time by asking yourself some or all of these questions:

Where am I?
What is today?
What is the date?
What is the month?
What is the year?
How old am I?
What season is it?
Who is the President?
List as many Grounding skills as you can.
Practice several grounding skills every day.

Construct a list of those which are most helpful and effective.

Goals When Using Grounding Techniques

To keep myself safe and free from injury. To reorient myself to reality and the here and now.
To identify what I attempted to do to prevent the dissociative experience.
To identify skills that I can use in the future to help myself remain grounded.

Goals Prior To Using Grounding Techniques

Learn as much as I can about dissociation, grounding techniques and triggers.
(What are the triggers that usually signal that I am about to dissociate?)
Practice, practice, practice, my grounding skills when I am in a stable, comfortable space so that I am prepared when I need them.
Make a list of the grounding techniques that work best for me and put it where I can easily refer to it when necessary.

DreamStalker

by **Butterfly Faerie** » Sun May 14, 2006 10:11 pm

Symptoms of PTSD

Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that follows a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. PTSD, once referred to as shell shock or battle fatigue, was first brought to public attention by war veterans, but it can result from any number of traumatic incidents. These include kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as a mugging, rape, or torture, or being held captive. The event that triggers it may be something that threatened the person's life or the life of someone close to him or her. Or it could be something witnessed, such as mass destruction after a plane crash.
Whatever the source of the problem, some people with PTSD repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day. They may also experience sleep problems, depression, feeling detached or numb, or being easily startled. They may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, more aggressive than before, or even violent. Seeing things that remind them of the incident may be very distressing, which could lead them to avoid certain places or situations that bring back those memories. Anniversaries of the event are often very difficult.

PTSD can occur at any age, including childhood. The disorder can be accompanied by depression, substance abuse, or anxiety. Symptoms may be mild or severe--people may become easily irritated or have violent outbursts. In severe cases they may have trouble working or socializing. In general, the symptoms seem to be worse if the event that triggered them was initiated by a person--such as a rape, as opposed to a flood.

Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A flashback may make the person lose touch with reality and reenact the event for a period of seconds or hours or, very rarely, days. A person having a flashback, which can come in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again.

Not every traumatized person gets full-blown PTSD, or experiences PTSD at all. PTSD is diagnosed only if the symptoms last more than a month. In those who do have PTSD, symptoms usually begin within 3 months of the trauma, and the course of the illness varies. Some people recover within 6 months, others have symptoms that last much longer. In some cases, the condition may be chronic. Occasionally, the illness doesn't show up until years after the traumatic event.

Specific Symptoms of this Disorder:
The person has been exposed to a traumatic event in which the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others and the person's response involved intense fear, helplessness, or horror.

The traumatic event is persistently reexperienced in one (or more) of the following ways:

recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
recurrent distressing dreams of the event.
acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated).
intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
The individual also has persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

efforts to avoid thoughts, feelings, or conversations associated with the trauma
efforts to avoid activities, places, or people that arouse recollections of the trauma
inability to recall an important aspect of the trauma
markedly diminished interest or participation in significant activities
feeling of detachment or estrangement from others
restricted range of affect (e.g., unable to have loving feelings)
sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

difficulty falling or staying asleep
irritability or outbursts of anger
difficulty concentrating
hypervigilance
exaggerated startle response
The disturbance, which has lasted for at least a month, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

by **Butterfly Faerie** » Sun May 14, 2006 10:11 pm

This is something that I learned to understand in therapy.

Conditioned Memory

A class of implicit memory includes behavior learned through classical conditioning (CC) or operant conditioning (OC).
Either or both of them can be involved in the learned trauma responses of those with PTS and PTSD.

Classical conditioning

The easiest place to start is with a little example. Consider a hungry dog who sees a bowl of food. Something like this might happen:

Food ---> Salivation
The dog is hungry, the dog sees the food, the dog salivates. This is a natural sequence of events, an unconscious, uncontrolled, and unlearned relationship. See the food, then salivate.

Now, because we are humans who have an insatiable curiosity, we experiment. When we present the food to the hungry dog (and before the dog salivates), we ring a bell. Thus,

Bell
with
Food ---> Salivation
We repeat this action (food and bell given simultaneously) at several meals. Every time the dog sees the food, the dog also hears the bell. Ding-dong, Alpo.
Now, because we are humans who like to play tricks on our pets, we do another experiment. We ring the bell (Ding-dong), but we don't show any food. What does the dog do? Right,

Bell ---> Salivate
The bell elicits the same response the sight of the food gets. Over repeated trials, the dog has learned to associate the bell with the food and now the bell has the power to produce the same response as the food. (And, of course, after you've tricked your dog into drooling and acting even more stupidly than usual, you must give it a special treat.)

This is the essence of Classical Conditioning. It really is that simple. You start with two things that are already connected with each other (food and salivation). Then you add a third thing (bell) for several trials. Eventually, this third thing may become so strongly associated that it has the power to produce the old behavior.

Now, where do we get the term, "Conditioning" from all this? Let me draw up the diagrams with the official terminology.

Food ---------------------> Salivation
Unconditioned Stimulus ---> Unconditioned Response

"Unconditioned" simply means that the stimulus and the response are naturally connected. They just came that way, hard wired together like a horse and carriage and love and marriage as the song goes. "Unconditioned" means that this connection was already present before we got there and started messing around with the dog or the child or the spouse.
"Stimulus" simply means the thing that starts it while "response" means the thing that ends it. A stimulus elicits and a response is elicited. (This is circular reasoning, true, but hang in there.) Another diagram,

Conditioning Stimulus
Bell
with
Food -----------------------> Salivation
Unconditioned Stimulus------> Unconditioned Response
We already know that "Unconditioned" means unlearned, untaught, preexisting, already-present-before-we-got-there. "Conditioning" just means the opposite. It means that we are trying to associate, connect, bond, link something new with the old relationship. And we want this new thing to elicit (rather than be elicited) so it will be a stimulus and not a response. Finally, after many trials we hope for,

Bell ---------------------> Salivation
Conditioned Stimulus ---> Conditioned Response

Operant Conditioning

Operant conditioning has been widely applied in clinical settings (i.e., behavior modification) as well as teaching (i.e., classroom management) and instructional development (e.g., programmed instruction). Parenthetically, it should be noted that Skinner rejected the idea of theories of learning.

1. Practice should take the form of question (stimulus) - answer (response) frames which expose the student to the subject in gradual steps

2. Require that the learner make a response for every frame and receive immediate feedback

3. Try to arrange the difficulty of the questions so the response is always correct and hence a positive reinforcement

4. Ensure that good performance in the lesson is paired with secondary reinforcers such as verbal praise, prizes and good grades.

1. Behavior that is positively reinforced will reoccur; intermittent reinforcement is particularly effective

2. Information should be presented in small amounts so that responses can be reinforced ("shaping")

3. Reinforcements will generalize across similar stimuli ("stimulus generalization") producing secondary conditioning

by **Butterfly Faerie** » Sun May 14, 2006 10:12 pm

Defense Mechanisms

We go through many, many changes as we move from infancy through childhood to adulthood. The one that came to mind for me the other day as I was holding a friend's new born baby in my arms and thinking about the psychological distance between his infant mind and my own, was a consciousness of all the personality defenses and coping strategies we learn while growing up; how important these things are for keeping us safe from the more predatory elements of our world, but also the openness we can lose as these defenses get built.

Personality defenses (coping techniques, defense mechanisms) are important things in that they strongly influence the ease with which people are able to form and maintain healthy relationships and reject unhealthy relationships. Developing organically in response to frustrating, difficult and painful situations and experiences, they function as the human equivalent of a computer firewall, helping to defend against hurtful and abusive relationships, while hopefully also allowing healthy and nurturing relationships to pass. Discriminating when to be defensive and when not to be defensive is key for health. You need defense to keep you safe from those who would mess with you, but you also need to know when to relax and let your defenses down so as to retain the capability for innocence, openness and healthy relationships. Defenses are important, an immune system unto themselves. They're worth spending an essay talking about.

Mapping the world and the self

Becoming defensive is all about learning to identify and avoid painful and dangerous situations. We are born mostly open and undefended. We learn to avoid painful and dangerous situations by learning to map or represent (in our heads, not on paper) the world and where the dangerous, painful things exist in the world. We start doing this even as very young children and continue it with ever increasing sophistication as we mature. As our representation of the world becomes more sophisticated, our ability to control, tolerate or avoid pain also becomes similarly sophisticated.

The first pains we become aware of are internal - having to do with instinctual drives such as hunger, elimination and emotion. These drives create tensions in our infant bodies that over time we learn to represent and react to. For example, we instinctually cry when we are hungry but probably can't initially distinguish the pain of hunger from other pains. Over time we learn to recognize and represent hunger pains as a distinct sort of painful signal that can be avoided by eating. More time goes by and we learn to request food, thereby cutting hunger pains off before they become compelling. This sort of self-knowledge and control is easy for adults, but it is a major learning project for infants and toddlers.

In addition to mapping our internal environment, we also start mapping our external social environment. We learn, for instance, that our initial infant-centric map of the world (“It's all about me”) doesn't predict what other people will do with great accuracy. In response, we develop a social map of the people we are in relationships with and what they are likely to do for us. Our social map helps us to avoid people who are likely to hurt us and approach people who are likely to help us. As before, most adults can make this discrimination more or less easily, but children take years to properly master such discrimination.

The degree to which representation or mapping of the self and the social world takes place is always in relationship with a person's developmental level. Infants and young children (who are not very developed, physically or mentally) have representations of the self and of others that are more primitive, while older children and adults tend to have more sophisticated self and other representations. A person's developmental level is influenced both by biology and by experience. Children act in childlike ways both because they are inexperienced, and because their brains are literally immature and not fully physically developed. The biological aspects of children's brain development work themselves out by the teen years, and thereafter (assuming everything else has gone well), further development and maturity is mostly a function of experience and personality. Not everyone is able to benefit from experience, however. Most everyone has probably met someone chronologically adult who functions to one degree or another in an immature, child-like and primitive way.

To read more of this article click on the link below.

Mental Health Net

by **Butterfly Faerie** » Sun May 14, 2006 10:13 pm

How does trauma affect relationships?

Trauma survivors with PTSD often experience problems in their intimate and family relationships or close friendships.

PTSD involves symptoms that interfere with trust, emotional closeness, communication, responsible assertiveness, and effective problem solving.

Survivors may experience a loss of interest in social or sexual activities, they may feel distant from others, and they may be emotionally numb.
Partners, friends, or family members may feel hurt, alienated, or discouraged because the survivor has not been able to overcome the effects of the trauma, and they may become angry or distant toward the survivor.
Feeling irritable, on guard, easily startled, worried, or anxious may lead survivors to be unable to relax, socialize, or be intimate without being tense or demanding. Significant others may feel pressured, tense, and controlled as a result.
Difficulty falling or staying asleep and severe nightmares may prevent both the survivor and partner from sleeping restfully, which may make sleeping together difficult.
Trauma memories, trauma reminders or flashbacks, and the avoidance of such memories or reminders can make living with a survivor feel like living in a war zone or like living with the constant threat of vague but terrible danger.
Living with an individual who has PTSD does not automatically cause PTSD, but it can produce vicarious or secondary traumatization, which is similar to having PTSD.
Reliving trauma memories, avoiding trauma reminders, and struggling with fear and anger greatly interfere with a survivor's ability to concentrate, listen carefully, and make cooperative decisions. As a result, problems often go unresolved for a long time.
Significant others may come to feel that dialogue and teamwork are impossible.
Survivors of childhood sexual and physical abuse and survivors of rape, domestic violence, combat, terrorism, genocide, torture, kidnapping, and being a prisoner of war often report feeling a lasting sense of terror, horror, vulnerability, and betrayal that interferes with relationships.

What can be done to help someone who has PTSD?

Survivors who feel close to someone else, who begin to trust, and who become emotionally or sexually intimate may feel like they are letting down their guard. Although the survivor often actually feels a strong bond of love or friendship in current healthy relationships, this experience can be perceived as dangerous.
Having been victimized and exposed to rage and violence, survivors often struggle with intense anger and impulses. In order to suppress their anger and impulsive actions, survivors mayaboidaaa avoid closeness by expressing criticism toward or dissatisfaction with loved ones and friends.
Intimate relationships may have episodes of verbal or physical violence.
Survivors may be overly dependent upon or overprotective of partners, family members, friends, or support persons (such as healthcare providers or therapists).
Alcohol abuse and substance addiction, which can result from an attempt to cope with PTSD, can destroy intimacy and friendships
In the first weeks and months following a traumatic event, survivors of disasters, terrible accidents or illnesses, or community violence often feel an unexpected sense of anger, detachment, or anxiety in their intimate, family, and friendship relationships. Most are able to resume their prior level of intimacy and involvement in relationships, but the 5-10% who develop PTSD often experience lasting problems with relatedness and intimacy.

Yet, many trauma survivors do not experience PTSD, and many people in intimate relationships, families, and friendships with individuals who have PTSD do not experience severe relational problems. People with PTSD can create and maintain successful intimate relationships by:

Establishing a personal support network that will help the survivor cope with PTSD while he or she maintains or rebuilds family and friend relationships with dedication, perseverance, hard work, and commitment
Sharing feelings honestly and openly with an attitude of respect and compassion
Continually strengthening cooperative problem-solving and communication skills
Including playfulness, spontaneity, relaxation, and mutual enjoyment in the relationship
What can be done to help someone who has PTSD?
For many trauma survivors, intimate, family, and friend relationships are extremely beneficial. These relationships provide:

1. Companionship and a sense of belonging, which can act as an antidote to isolation

2. Self-esteem, which can act as an antidote to depression and guilt

3. Opportunities to make a positive contribution, which can reduce feelings of failure or alienation

4. Practical and emotional support when coping with life stressors

As with all psychological disturbances, especially those that impair social, psychological, or emotional functioning, it is best to seek treatment from a professional who has expertise in both PTSD and in treating couples or families. Many therapists with this expertise are members of the International Society for Traumatic Stress Studies, whose membership directory contains a geographical listing and an indication of those who treat couples or families and PTSD. Survivors find a number of different professional treatments helpful for dealing with relationship issues, including individual and group psychotherapy for their own PTSD, anger and stress management, assertiveness training, couples communication classes, family education classes, and family therapy.

NCPTSD Website

by **Butterfly Faerie** » Sun May 14, 2006 10:14 pm

Understanding Memory Storage and Recall

The Fragmentary Nature of Memory Storage in Unresolved Traumas

When a traumatic event occurs, we may be confronted with an overwhelming amount of information in the form of images, emotions, physical sensations, smells and sounds. It appears that under such conditions, the brain becomes overloaded with large volumes of information. The resulting neurochemical changes disrupt normal processing of this information, causing memories to be subsequently stored as fragments in their original distressing/disturbing state.

These memory fragments are stored in "associative networks" in which related thoughts, memories, images, emotions, and sensations are linked together (Shapiro, 1995; Lang, cited in van der Kolk, 1994). For example, an adult rape survivor who has also experienced childhood sexual abuse may have memory fragments of her most recent rape experience stored together with similar memories from her earlier experience(s). Later, discussion of an aspect of one event may trigger the recall of similar aspects of the other. This can happen even in situation where the client had no recent recollection of the past trauma. In either event, further exploration may trigger the recall of additional fragments.

The Accuracy of Memory Recall

The retrieval of memories typically re-activates a process of wanting to make sense of the new material -- to give the memories meaning and to find the words needed to fully describe the impact that the original event had. This process can be something like putting together a jigsaw puzzle -- but without the help of the picture on the outside of the box. As more and more pieces of the "puzzle" become available through additional work in therapy, the client's overall understanding of what happened can change, sometimes dramatically.

For this reason, an additional word of caution is well advised: For clients who first begin recovering previously repressed memories (especially if this occurs PRIOR to the completion of much of their therapeutic work), it can be a big temptation to trust one's first attempt to "fit" the pieces together and (in the case of some human-perpetrated traumas) confront the perpetrator(s). Consider the client who recalled in treatment having been sexually abused as a child. Among her initial memory fragments she recovered one that was an image of her father's face and assumed him to have been the perpetrator. Later, after more work in therapy, she recalled additional pieces of the puzzle and realized that the image of her father was from when he had come to her rescue and that the perpetrator had been someone else. This example illustrates the importance of delaying any confrontations of perpetrators until the bulk of your therapeutic work has been completed and you have had plenty of opportunity to seek corroborating evidence that supports the story you construct using recalled memories.

It is very difficult to know whether one's memories are accurate representations of past traumas. There are several different types of information that may be later retrieved during therapeutic work. In addition to memory fragments that are experienced by the client as having an accurate resemblance to the original trauma, there may be

fragments of dreams that were symbolic of emotional conflicts,
screen memories (memories that defensively cover up more distressing details of the same event),
memories that are distorted by the client's desire to see the situation (or individual in it) in a different light,
memories of trauma(s) witnessed by the client that actually happened to someone else, and
memories that are vague or distorted due to dissociative defense used to cope during the trauma.

It is important to know that mental health professionals cannot validate the historical truth of any memory. This is one of the limitations of psychotherapy and validation is something you would have to establish for yourself with independent corroboration.

This information is also not meant to discount the impact of your suffering nor to suggest that you not discuss the material that emerges in your treatment. These recollections (despite the issue of accuracy) are what shape self-esteem, influence behavior, and provide meaning and perspective for one's life.

Trauma & Memory

by **Butterfly Faerie** » Sun May 14, 2006 10:15 pm

Triggers and Desensitization

"Throughout the course of a day your senses and perceptions take in an enormous amount of data which they correlate and then translate into reactions. These reactions may be in the form of thoughts, words, actions, or beliefs. Every reaction an individual has is totally based on past experience or experiences that the individual's mind correlate as being as close to the current situation as possible. Reactions can change as the focus of the individual's thoughts and concerns change. As an individual recovers their abusive history, their focus is changed and subsequently their reactions are also changed.

Triggers are words, symbols, situations, items, sounds, smells, colours just about anything that the mind correlates to a negative past experience and causes a reaction based on it. As an individual's focus changes, things that once did not cause them to react, now do. However, the reverse is also true. As the individual comprehends these triggers and integrates a new meaning of them into their perceptions OF THEIR OWN CHOOSING, then what was once a trigger is no longer. It is a simple as that, however, the practicing can take some time, dedication and determination on the part of the survivor. Even triggers that are part of a programmed response for a survivor are defused under essentially the same principle.

Part of what makes dealing with triggers so difficult is in determining what the trigger is exactly. Some survivors hace a delayed reaction to some triggers. Triggers can also be cumulative in nature. For instance, a survivor encounters three distinct or dominant sounds over a two day period that exactly match the sounds experienced from the past. No reponse or even cognitive recognition may occur for the first two sounds, but at the third one, the survivor has a distinct reaction. It is difficult for the survivor to retrieve the first two sounds and may therefore not connect that the third sound was the final part of the trigger, especially if there were many other things occurring at the same instant that the third sound went off. The survivor may be looking to one of those rather than at the sound. For instance the third sound may have been a buzzer on the microwave or alarm clock, which the survivor hears on a regular basis without any negative reaction at all. But, that same buzzer in connection with two other preceding sounds made the cumulative stimuli into a trigger creating a notable reaction.

In order for a survivor to begin determining what is triggering them, they must listen to their body sensations and responses. Even at the first sound the survivor might have felt their stomach tighten, felt a brief moment of switching (as their mind was logging the sound) or felt a flash of emotion (such as anxiety or fear). It may have lasted only for a second but because the survivor did not note or recognize what their body was trying to tell them, the event passed without being dealt with....a survivor, multiple or not, never thinks says or does or believes ANYTHING without a reason. It does not matter the degree, type or longevity of the abuse survived, just any survivor. That makes up the majority of humans living on the face of the earth. If a survivor will listen to their body realizing that there IS a reason why it is doing or feeling what it is, then they can begin the process of desensitization and deprogramming. It is the first and most crucial step in both processes.

Look at how much time you, as a survivor, multiple or not, spend on your own practicing new coping skills and mechanisms or how much time you spend getting in touch with your body that your level of committment begins to show.

Take a few minutes to write beside each of the following things in this list how much time per week you spend on them. It does no good to deceive yourself or increase the true amount. It is time to get honest with yourself about your survival. Do not answer on a 'per average week' basis. How much time did you spend LAST WEEK on the following things. You may find it helpful to keep a running track from week to week so taht you are allotting the time that is required to effectively meet the responsibilites to yourself and your survival.

How Much Time Did You Spend This Week On:

1. Learning a totally new coping skill? ______________
2. Practising a totally new coping skill? ______________
3. Getting in touch with your body
sensations through massage or other
means? ______________
4. Being consciously aware of your body
signals? ______________
5. Learning about your current coping
skills? ______________
6. Preparing, through various types of
journalling or mapping, for your next
therapy session? ______________
7. Discovering why, what, and who inside
your Unit/system reacted to a certain
situation in a certain way? ______________
8. Why you were feeling depressed, angry
or any other feeling(s) in a specific
situation, past or present? ______________
9. Letting your various child components
(if multiple) or inner child side
(if non-multiple) out to do something
they wanted to do? ______________
10. Direct open-minded communication with
your child components or inner child
side? ______________
11. Direct interaction with your child
components or your inner child side?
(The adult being with the children or
adult side with the child inside,
playing, singing, or doing a project
TOGETHER? ______________
12. Giving yourself and/or your components
positive affirmations and/or comments? ______________
13. Giving yourself and/or your components
positive reinforcement by looking at a
situation that might have been
difficult or negative and looking for
the good or positive? _______________

If your answer is you didn't have time, take a look for a moment at how much time you spent in a state of crisis or dysfunction. Taking a little extra time to work on the things in the list above will reduce the amount of time you spend in crisis and dysfunction...The degree to which you take responsibility and make conscious choices is the degree to which your life will by yours again.

Once you start listening to your body you will start unravelling the 'trigger mystery'. Then what? In some cases, simply recognizing what the trigger was taht caused a certain response, then discovering what past experience or experiences the trigger(s) is correlating to, will release the significance. I call it association defusing. Associating A: the trigger + B: the experience = C: realization and defusion of the trigger. This is especially true of non-programmed trigger reponses. For the majority of survivors, association with perhaps a little therapy around the recalled experience will end the significance and power of the trigger(s).

There is no set group of triggers that are universal to all or the majority of survivors, programmed or not. Triggers can also be calender dates, celestial conditions and/or major holidays. Survivors need to be especially careful that they do not set up (consciously or unconsciously) a response to a trigger because they learn that other survivors with seemingly similar histories or stories, react to that trigger. Reaction to a predisclosed trigger DOES NOT validate your memories. Nor does the way in which you react validate your memories. You must validate your own memories and experiences.

For programmed survivors (survivors who hae been purposefully and methodically conditioned to repond in a specific way to a specific trigger) the solution is a little more complex and time consuming. Trigger responses of a programmed nature have a sequential life of their own. They have a pattern and a chain of psychological and/or physiological reactions that take place. The survivor must unravel not only A: what the trigger is, B: what the experience(s) is, but also C: what the instructions were, D: who gave the instructions [if not name of individual then the perceived significance of the individual or voice] E: what were the ramifications, either realized or perceived, to not giving the proper reaction, all before the survivor can fully comprehend how it equals to F: the trigger response.

I do not recommend that a programmed survivor attempt to go through this process without the assistance of a trained and qualified therapist. It is extremely easy to lose touch with reality as a programmed survivor and in many cases, you can be actually reinforcing the programming rather than defusing or at least disarming it.

In order to totally defuse the trigger response a survivor must complete the aforementioned equational steps, however, the survivor can begin desensitization to the trigger which will disarm it temporarily while working on defusing. It is important that you do not leave a programmed trigger in the disarmed state. If a cult perpetrator wished to reactivate a programmed trigger response that has only been disarmed it is a relatively simple procedure. Just because a survivor no longer reacts to a trigger does not necessarily imply that they have discovered and are cognizant of why it triggered then in the first place.

Desensitization

Desensitization involves establishing a new more desirable conditioned response to a trigger. In other words, changing the old trigger to a new one. As you can see, it does not mean that the survivor no longer responds to the trigger. What it does mean is that they respond in a different and hopefully more positive and productive way of their own choosing. I caution survivors to take an active role in determining what that new response should be. Only you can determine if it is actually more positive and productive internally.

Desensitization typically takes the form of subjecting the survivor to a known trigger in a controlled, supportive environment in longer and longer periods of time until they are able to respond with the new, preestablished response. Then they are exposed to the trigger under less controlled circumstances with the survivor's normal environment while still accompanied by a support person until they are able to respond with the new response. The final step is to have the survivor experience the trigger under normal circumstances with a normal environmental setting until they can respond with the new response. The final step is to have the survivor experience the trigger under normal circumstances within a normal circumstances within a normal setting until they are able to repond with the new response. When they are capable of doing the final step, they should be able to encounter the trigger in any situation and use the new response that has been made instinctual by the above outlined process. This is the technique of many phobia experts. It can be a rather long and drawn out process depending upon the determination of the survivor to change the trigger response and how ingrained or habitual the old trigger has become.

There are no true shortcuts for successful desensitization. Many therapists and survivors skip steps here and there or stop after the first time the new response is used.

Other trigger responses, usually programmed, that could require initial desensitization are self-mutilative acts, suicidal acts, homicidal acts, reporting a person to a cult programmer or perpetrator, sexual acts, eating habits and so forth".

by **Butterfly Faerie** » Sun May 14, 2006 10:15 pm

Posttraumatic stress disorder (PTSD) is an anxiety disorder that a person may develop after experiencing or witnessing an extreme, overwhelming traumatic event during which they felt intense fear, helplessness, or horror.

The dominant features of posttraumatic stress disorder are emotional numbing (i.e., emotional nonresponsiveness), hyperarousal (e.g., irritability, on constant alert for danger), and reexperiencing of the trauma (e.g., flashbacks, intrusive emotions).

Posttraumatic stress disorder is also referred to as shell shock or battle fatigue (when describing the disorder in combat veterans) and as postrape syndrome.

Trauma

A trauma is an intensely stressful event during which a person suffers serious harm or the threat of serious harm or death or witnesses an event during which another person (or persons) is killed, seriously injured, or threatened. Traumatic events are commonly classified as follows:

Abuse
Mental
Physical
Sexual
Verbal (i.e., sexual and/or violent content)
Catastrophe
Harmful and fatal accidents
Natural disasters
Terrorism
Violent attack
Animal attack
Assault
Battery and domestic violence
Rape
War, battle, and combat
Death
Explosion
Gunfire

Types of PTSD

There are three types of PTSD: acute, chronic, and delayed onset. In acute PTSD, symptoms last less than 3 months. In chronic PTSD, symptoms last 3 months or more. In delayed onset PTSD, symptoms first appear at least 6 months after the traumatic event.

Incidence and Prevalence

Lifetime prevalence is at least 1% and may be as high as 15% in the U.S. population. A National Comorbidity Survey conducted in the early 1990s found that women are twice as likely as men to experience PTSD. In high-risk groups, such as combat veterans and victims of violent crimes, prevalence ranges from 3% to 58%.
PTSD is more prevalent among war veterans than among any other group. The National Vietnam Veterans Readjustment Survey reports that approximately 25% of U.S. veterans, men and women, were suffering from PTSD in the early 1990s.
Men with PTSD identify combat and witnessing someone else's injury or death most often as the cause of their condition. Women identify physical attack or threat most often as the cause of their PTSD.

Someone with PTSD is at risk for developing other mental health disorders such as panic disorder, phobias, major depressive disorder, and obsessive-compulsive disorder.

PTSD commonly occurs in countries where long-term war, widespread social upheaval, and frequent natural disasters are prevalent.

Mental Health Channel

Information Thread: PTSD

Information Thread: PTSD

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